Blog

This patient presented with a retinocytoma of the right eye. The OCT line scan shows a disorganized, thickened retina. Typical intralesional calcification is noted. This calcium is highly reflective, causing shadowing of the underlying retina. Clinically, retinocytomas can resemble astrocytic hamartomas. However, retinocytomas often have underlying RPE changes and chorioretinal scarring, which are not present… Read More

Our patient shows fairly classic findings of fundus flavimaculatus. Central vision remains good at 20/40 OD and 20/30 OS, with preserved foveas. Findings include bilateral macular atrophy and scattered yellow, subretinal, multifocal, and autofluorescent flecks extending to the mid-peripheral retina. OCT shows RPE and outer retinal atrophy. Learning Points: Fundus flavimaculatus is a genetic disorder,… Read More

This 59YO female initially had unilateral multifocal choroiditis (MFC) in her left eye. When we started seeing her in the mid-1990s, predating the anti-VEGF era, we battled multiple inflammatory macular neovascularizations (MNV). Eventually, she developed subfoveal MNV and nasal subretinal fibrosis despite multiple thermal laser treatments, and her vision remains counting fingers OS. Fourteen years… Read More

This asymptomatic patient was noted to have a choroidal osteoma. As choroidal lesions, osteomas are best seen on the red channel compared with the green Optos channel. Ultrasonography is often helpful in differentiating an osteoma (markedly hyperreflective) from other amelanotic choroidal tumors. Learning Points: Choroidal osteomas are benign, calcified amelanotic choroidal tumors. They are more… Read More

This 76yo male was asymptomatic when he presented with multiple, irregular congenital hypertrophy of the RPE (CHRPE) lesions in both eyes (only the left eye pictured). He had a known family history of familial adenomatous polyposis (FAP) or Gardner’s Syndrome. Annual screening colonoscopies have been normal. Learning Points: FAP is an autosomal dominant syndrome associated… Read More

This patient had hand motion vision in her left eye from a closed funnel, combined with diabetic tractional and rhegmatogenous retinal detachment. Along with vitrectomy, a 360-degree retinectomy was made anterior to the macula. The posterior retina was then flattened with Perfluoron, followed by silicone oil. A large macular hole was also noted intraoperatively. This… Read More

Peripapillary intrachoroidal cavitation is a relatively rare abnormality most commonly found in high myopia. Clinically, these subretinal lesions have an orange coloration and are usually located inferior to the optic nerve. OCT scanning of the central macula shows a variety of typical myopic findings, including posterior bowing of the sclera, variable attenuation of the ellipsoid… Read More

This patient’s vision remained 20/100 one month following vitrectomy with subretinal tissue plasminogen activator. Surgery accomplished its goal of displacing most of the subfoveal blood, which is variably red and devitalized (yellow). OCT shows the remaining subretinal hyperreflective blood, the causative sub-RPE type 1 macular neovascularization, and a subfoveal prechoroidal cleft. Learning Points: A prechoroidal… Read More

This 83YO female has extensive, confluent drusen outside the perifoveal area. The drusen, located beneath the RPE, are well visualized with the Optos red channel. Subretinal drusenoid deposits (not present), which form above the RPE, would disappear with the red channel. OCT also demonstrates drusen. Learning Points: Sub-RPE drusen are a hallmark feature of non-exudative… Read More

This 64YO female presented with 20/30 vision OD and no light perception OS. Her blood pressure was elevated at 147/101, and she had a history of type 2 diabetes. She had a prior macular laser for macular edema. Although clinically the peripheral retina appeared ischemic, fluorescein angiography showed dramatic, extensive, and total peripheral ischemia OD,… Read More